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Myocardial contrast echocardiography in biopsy-proven primary cardiac amyloidosis

Sahar S Abdelmoneim1, Mathieu Bernier, Diego Bellavia

  • 1Mayo Cardiovascular Ultrasound Imaging and Hemodynamic Laboratory, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|May 21, 2008
PubMed

Insights

Myocardial contrast echocardiography (MCE) effectively detects microvascular dysfunction in primary cardiac amyloidosis (CA). This ultrasound technique aids in early diagnosis when coronary arteries appear normal.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Primary cardiac amyloidosis (CA) significantly affects cardiac vasculature in most patients.
  • Microvascular dysfunction is a key feature in CA, impacting myocardial blood flow.
  • Myocardial contrast echocardiography (MCE) visualizes intravascular microbubbles to assess microvascular function.

Observation:

  • This case report details the first use of MCE with vasodilator stress in a patient with biopsy-proven primary CA and normal coronary angiograms.
  • Qualitative MCE showed delayed microbubble replenishment during peak stress.
  • Quantitative MCE revealed reduced total myocardial blood flow and reserve.

Findings:

  • MCE identified microvascular dysfunction in a patient with primary CA.
  • The technique demonstrated reduced myocardial blood flow and reserve capacity.
  • Comparative imaging supported the diagnosis of CA.

Implications:

  • MCE is a valuable tool for recognizing microvascular dysfunction in CA.
  • This method can augment echocardiographic assessment for early CA diagnosis.
  • MCE may improve diagnostic accuracy in challenging CA cases.

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